Consumers FAQ

PRIVATE PASSENGER AUTOMOBILE INSURANCE

Q.        What coverages are mandatory? 
A. Every car owner must have liability coverage. Liability coverage pays for any claims when you are at fault in an accident. The minimum liability you are required to carry by law is $ 25,000 per person for bodily wound, $ 50,000 per accident and $ 25,000 to cover place damage to early ’ mho property. Almost all insurers offer higher limits. When you apply for liability coverage, you must be offered an opportunity to purchase coverage for uninsured motorist bodily and place price, underinsured motorist coverage for bodily injury and personal injury security coverage .
Uninsured motorist coverages cover you and your car if the other driver is at fault and does not have liability indemnity .
Underinsured motorist coverage gives you extra auspices if the early driver is at defect and doesn ’ t have adequate coverage to cover your injuries.

personal Injury Protection provides you with engage passing, death benefits and aesculapian coverage regardless of mistake .
Q.        What other coverages are available?
A. You may besides purchase comprehensive and collision coverages. comprehensive coverage protects against damage to your automobile from acts of nature or early events not associated with operating the automobile. Collision coverage protects against damage to your car when it is involved in an accident .
Q.        Are there any discounts that must be offered? 
A. Yes, the College Graduate Discount and Defensive Driver Discount for those insureds 55 and over who have successfully completed a class approved by the Office of Driver Services. Check with your agent for any other discounts your insurance company may offer .
Q.        Why have my rates gone up when I haven’t had an accident and/or claim?
A. credibly because the insurance company increased its overall rates because it has paid out more losses than expected. You may personally receive a lower or higher rate based upon diverse factors .
Q.        Why haven’t my physical damages premiums decreased as my vehicle ages?
A. The price of repairing vehicles does not go down vitamin a a vehicles ages .
Q.        Will my policy cover me if I rent an automobile?
A. This can vary by ship’s company. You should ask your agent if your policy covers you, those you might injure if at fault, and the lease means ’ s automobile .

 HOMEOWNERS INSURANCE

Q.        What coverages are mandatory?
A. You are not required to have homeowners coverage by any Arkansas law. however, if you have a mortgage on your home, you may be required by your mortgage agreement or loanword agreement to carry wax coverage or be in breach of your agreement. Your lend institution may have more information on what levels of coverage it requires you to maintain .
Q.        What different types of homeowners coverages are available?
A. There are respective unlike types, but most homeowners carry full coverage for all perils including losses associated with any sudden and accidental event. In the encase your home is wholly destroy, you may wish to consider having replacement price coverage indeed that you can rebuild your home. The all perils coverage normally includes coverage for your liability to your guests .
other types of homeowners policy cover only fuel and weather events. Some are designed specifically for renters .
Q.        Can insurance companies use my credit information to deny me insurance or to increase the premium I pay?
A. An insurance caller may use credit AS PART of the process of determining whether coverage will be provided and what it costs. A consumer booklet on use of credit in homeowners and personal automobile insurance is now available. This booklet, “ Understanding How Insurers Use Credit Information, ” contains data about Act 1452 of 2003 and its affect on the use of credit information in homeowners and personal automobile indemnity underwrite and rate .
Q.        What is a public protection classification?
A. a rat determined by the equipment, manpower, urine beginning and other factors of a fuel district. Classifications range from 1 to 10, with 10 being a very rural area with identical little fire protective covering .
Q.        Who determines a public protection classification?
A. The Insurance Services Office, or ISO, inspects local fire departments and sets the categorization .
Q.        How does it effect my homeowners premium?
A. by and large, the lower the protection class rate the lower the basal premium. You can contact your local fire department and ask them for their “ ISO public protection class rating ” .
Q.        What is the difference in replacement cost (RC) and actual cash value (ACV)?
A. ACV allows for depreciation in determining how much to pay you on your claim while substitution cost does not .
Q.        How do I know what type of policy I have (RC or ACV)?
A. You may wish to contact your agent. You can besides read the loss village planning of your policy .
Q.        Why have my rates gone up when I haven’t filed any claims?
A. credibly because the insurance company increased its overall rates because it has paid out more losses than expected. You may personally receive a lower or higher pace based upon assorted factors .

INSURANCE PREMIUMS

Q.        Does the Insurance Department set insurance rates?
A. No, that is a common misconception regarding the Department ’ s supervision of rates. Proposed rate changes by insurers must be filed with the Arkansas Insurance Department at least twenty dollar bill ( 20 ) days prior to the effective date. We have broad authority to review how the pace is distributed among insureds according to factors that might predict future losses, but we cannot disapprove an overall rate unless it is actuarially “excessive, inadequate or unfairly discriminatory.”
“Excessive.”   A rate becomes excessive when the loss ratio ( losses divided by premiums paid ) drops to a target which results in the policy company earning an excessive measure of profit .
“Inadequate.”   A rate is inadequate if it will lead to solvency problems immediately or has the electric potential for long-run solvency implications in that it may not provide sufficient fund to pay future claims, the costs of adjusting those claims and operating the commercial enterprise .
“Unfairly Discriminatory.”   All indemnity discriminates among versatile risks. There is “ carnival, ” i, “ legal ” discrimination, and “ unfair, ” i.e., illegal discrimination. Cross-subsidies encourage bad behavior in some risk categories. consequently, allocating the premiums among risks tends to discourage hazardous behavior. “ Unfair ” discrimination basically means not treating similar risks the same in rates and coverages .
Q.        What rates are reviewed?
A. We review life sentence, health, secret passenger car, homeowners, workers ’ compensation and master liability policy rates .

WORKERS COMPENSATION

Q.        What part does the Arkansas Insurance Department play in workers’ compensation issues and claims?
A. The Arkansas Insurance Department is merely involved in approving what rates and forms policy companies use to insure the employer. We have no part in the determination of whether a claim is covered under workers ’ compensation. That province rests with the Arkansas Workers ’ Compensation Commission .

HEALTH INSURANCE

  Q.        What is a “pre-existing condition”?
A. It is a health condition you had before you purchased your health policy coverage, such as cancer, regardless of whether you received a diagnosis or treatment before the purchase. Health carriers can sometimes refuse to cover your preexistent conditions .
Q.        When can my health insurance carrier exclude coverage for my pre-existing conditions?
A. There are several circumstances in which your health carrier can refuse to cover your preexistent conditions. preexistent conditions can always be excluded if you buy an individual health policy policy. For group health policies, preexistent conditions can only be excluded under the follow circumstances :

• The pre-existing condition exclusion relates to a mental or physical condition for which medical advice, care, etc. was recommended or received within the 6 month period ending on the enrollment date (date of hire);

• The exclusion can’t last more than 12 months (or 18 months for a late enrollee) after the enrollment date; and

• The exclusion period must be reduced by creditable coverage.  Creditable coverage is virtually any kind of coverage the person had before enrolling in the present coverage, but not workers compensation, liability insurance, or any of the excepted benefits listed in Ark Code Ann. §23-86-310.  However, if a person has coverage, followed by break of 63 days, that prior coverage does not count as creditable coverage!  To illustrate, suppose an individual had coverage for 2 years followed by a break in coverage of 70 days and then resumed coverage for 8 months.  That individual would only receive credit for 8 months of coverage; no credit would be given for the 2 years of coverage prior to the break in coverage of 70 days.

Q.        Can my pregnancy be excluded as a pre-existing condition?
A. In a group health plan, No ; under an individual policy, Yes. If you are going to buy an individual policy, always buy a motherhood rider if you may become meaning !
Q.        I have been offered a health insurance policy by a company I have never heard of.  The rate is very low, and this looks too good to be true!  Should I buy it?
A. Unauthorized health indemnity has been a big trouble in Arkansas in holocene years. Hundreds of Arkansas consumers have purchased indemnity from companies they thought were legitimate, entirely to be left with thousands of dollars in amateur medical claims .
Keep in mind that if something looks besides good to be true, it probably is ! Always call the Arkansas Insurance Department if you are uncertain about an indemnity product you are offered. We can check to make certain that both the policy carrier wave and producer offer it are properly licensed. here are some other danger signs :

• Beware if a licensed insurance agent attempts to sell you health coverage that claims to be an ERISA plan.

• Be skeptical if the plan offers coverage without pre-existing condition exclusions.

• Investigate offers that avoid the word “insurance” or the use of insurance terminology.

• Watch out for terms like “consultant fees” (instead of commissions) and those that refer to payments as “contributions.”

• Be skeptical if companies fail to disclose name of carrier for products they claim to be “fully insured” or “fully funded.”

• Investigate a company if enrollees are required to join and pay dues to an “association” to obtain health coverage.

Health dismiss cards are regulated by the Arkansas Attorney General. If you have questions about health discount cards, please contact the Attorney General ’ s office at 1-800-482-8982 .
Q.        What is Arkansas’s Any Willing Provider Law?
A. Arkansas ‘s “ Any Willing Provider Law ” provides that persons in group or individual health plans or HMOs will be able to go to the doctors or hospitals of their choice, if the doctor or hospital agrees to the terms and conditions of that person’s health insurance company or HMO .
Q.        How long does a health insurance company have to pay a health insurance claim?
A. Health insurance companies, including HMOs, have 30 days to pay a claim to either you or your medical supplier, if the claim is electronically filed with the health policy ship’s company. If the claim is mailed to the health policy company, the health indemnity company has forty-five days to pay the claim. All of these time deadlines assume that the title is considered a “ clean claim, ” or a title falling squarely under coverage under the health plan, in which no further information is needed by the health insurance company to process the call. If the title is however not “ clean ” or the health insurance company needs more information to process the claim, the health insurance company is allowed 30 days to collect the information, and after all of the command information is received by the health insurance company, the 30 ( electronic ) and 45 ( non-electronic ) day payment rules then apply .
Q.        Is Maternity a mandated benefit? 
A. No, it is not mandated by the Arkansas Insurance Department. Complication of Pregnancy is a cover profit. In employer groups of more than 15 employees, Title VII of the Civil Rights Act of 1964 states that any health insurance provided must cover expenses for pregnancy-related conditions on the same footing as expenses for other medical conditions .
Q.        Is In-Vitro Fertilization a mandated benefit? 
A. Yes, refer to ACA §23-85-137, ACA 23-86-118 and Rule and Regulation 1. It is a benefit on a policy which provides normal pregnancy-related benefits. It does not apply to HMO ’ s or to self-insured plans .
Q.        In what situation is a newborn automatically covered under an insurance policy?
A. Under ACA §23-79-129 – If an insured has a policy ( individual or group ), that covers the see and at least one syndicate member ( spouse or child ), then a neonate must be covered from parentage for at least 90 days. If an guarantee has an individual policy or certificate with no dependents, in most situations, the newborn will have to go through underwrite unless differently stated by sign language .
Q.        Is there a state continuation law for health insurance?
A. Yes, department of state sequel is for 120 days as outlined under ACA 23-86-114 .
Q.        Can a medical provider file a complaint with the Department for slow payment issues against a health insurer or HMO?
A. Yes. The Department, however, requires that the checkup provider provide evidence in the complaint showing a “ model of dull requital ” practices by the health insurance company or HMO .
Q.        Are there statutes or Rules concerning the use of age and gender as underwriting criteria in Arkansas?
A. Yes. An insurance company should consider the relevant provisions of the Arkansas Trade Practices Act, Ark. Code Ann. § 23-66-206. however, if old age and sex are proven to be a substantial factor as an cover standard by the allege differentiator, then an insurance company is not prohibited from using it as a standard to charge different rates to different customers .

 EXTERNAL REVIEW

Q.        What is external review? 
A. An freelancer review of claims for benefits ( treatment or services ) to see if they are medically necessary or experimental/investigational. The requested benefit must be at least $ 500 for external review to apply .
Q.        What if I need the requested treatment as soon as possible? 
A. You may qualify for expedite external review, where a decision is rendered a soon as necessity, but no belated than 72 hours after the IRO receives the request for external review .
Q.        What type of plans does external review apply to? 
A. All health indemnity plans, except specified disease, circumscribed supplement benefit, long-run concern insurance, self-insured plans, CHIP pond, Medicare, WC, or car med give. ( For more specifics, see incision 1 einsteinium )
Q.        What if I, or my health insurance carrier, don’t like the IRO’s decision?

A. then you can file a lawsuit. Both the health carrier and the cover person have the right to go to court .
Q.        Who can request external review? 
A. The person covered under the health indemnity policy and/or that person ’ s authorized representative. An “ authorized congressman ” is :

• A person to whom a covered person has given express written consent to represent the covered person in an external review;       

• A person authorized by law to provide substituted consent for a covered person; or

• When the covered person is unable to provide consent, a family member of the covered person or the covered person’s treating health care professional if a family member is unavailable.

Q.        Who performs external reviews? 
A. An freelancer review administration ( “ IRO ” ) certified by the Department. It is independent of both the insurance company and the covered person .
Q.        When can I request an external review? 
A. After your claim for treatment or services, which have to be at least $ 500, has been denied as being not medically necessity or as being experimental/ investigational. broadly, you have to exhaust your heath carrier wave ’ s internal solicitation summons before requesting external review .
Q.        When do I have to request an external review? 
A. You have sixty days after you receive an initial denial or a final examination denial ( after the carrier ’ sulfur inner appeals process is completed ) .
Q.        Where can I find out about external review? 
A. Your health insurance carrier wave should provide this information in your policy. besides, your health carrier is required to give you information about your right to an external review after it initially denies payment for your claim as not being medically necessary or as being experimental/investigational. Most carriers have an internal appeals procedure, and if your claim is still denied after the inner appeals process, your carrier must again tell you about your right to external review .
Q.        Where can I find out more about external review? 
A. You can call your health aircraft carrier or the Arkansas Insurance Department .
Q.        How do I request an external review? 
A. Your health carrier wave will give you this information in your policy and after your claim is denied .

Q.        How long does it take the IRO to complete an external review?
A. Within 45 calendar days of the IRO ’ s reception of the request for the external reappraisal. For an expedite reappraisal, the revue is completed a soon as necessary, but no former than 72 hours after the IRO receives the request for expedite review .
Q.        Why does external review only apply to claims that are denied as not being medically necessary or as being experimental/investigational?
A. Because other terms in your policy policy are agreed upon by you or your employer when you sign up for the coverage. Doctors can differ, though, on what is experimental/investigational or medically necessary .

MISCELLANEOUS

Q.        Are Professional Employer Organization services (PEO) licensed in Arkansas?
A. Yes. By using our company Search database you can find out if person offer PEO services holds a valid license to sell those services. You can besides get a complete list of every licensed PEO doing business in Arkansas .
Q. What is the difference between a PEO and an Employee Leasing Firm?
A. none. In 2003, the name of the license was changed from an Employee Leasing license to a Professional Employer Organization license. The definition of what constituted these business was not changed .
Q.        Is there insurance available for damage caused by earthquakes?
A. Yes. A market Assistance Program ( MAP ) has been developed as a result of the Arkansas Earthquake Authority Act of 1999. The MAP is designed to assist consumers who are unable to find residential earthquake indemnity through traditional sources. extra information is available by calling 1-800-852-5494 .
On homeowners coverages, your company must tell you if it does not offer earthquake coverage and provide you with information on how to obtain coverage through the MAP .
Q.        High-risk insurance pools, what are they and how do I find them?
A. high gamble pools are designed to provide coverage for consumers who are unable to secure policy in the voluntary marketplace. The place and Casualty Division of the Arkansas Insurance Department manages the residual or assigned risk plans for workers ‘ compensation and car indemnity. additionally, fuel policy is available through a rural Risk Underwriting Association, which provides coverage for structures located in rural areas — where coverage is not available in the voluntary commercialize. Contact your indemnity agent for specifics .
  here is a number of the administrators of the versatile pools :
National Council on Compensation Insurance ( NCCI )
fiddling Rock, AR-501-834-9123 or 1-800-622-4271
Arkansas Rural Risk Underwriting Association ( ARRUA )
1-800-272-6588 ( Arkansas merely )
1-800-233-2398 ( out of state )
Arkansas Automobile Insurance plan
( Agents merely … Consumers must access this plan through their indemnity agent. )
1-800-413-5808
earthquake Market Assistance Program
1-800-852-5494
  Q.        What is “Surplus Lines” and when can I buy insurance from a surplus lines company?
A. When accredited insurers are unwilling or ineffective to provide necessitate coverage, you may secure coverage with an approve excess credit line insurance company through a accredited excess line agent. Individuals or corporations may secure policy coverage directly from a non-admitted insurance company. This coverage is considered “ self-procured. ” Your agent can help you if surplus lines coverage is required .
Surplus lines insurance is regulated by Rule 24 .
Q.        Does the Arkansas Insurance Department license or regulate premium finance companies?  
A. We do not. Federal and State Bank regulators do that, along with U.S. Attorney and the Arkansas Attorney General. Contact the Arkansas Attorney General on-line via links from the State web site at www.ag.arkansas.gov .
Q.        May producers charge insureds fees over and above gross premiums charged by carriers on the policies delivered to the insureds? 
A. In general, Ark. Code Ann. § 23-66-310 allows a manufacturer to charge a fee in excess of the premiums angstrom long as :
            a. The fee is individually disclosed on the insure ’ second bill ; and
barn. The tip does not exceed 20 % of the premium .
Q.        May I buy an insurance policy on other people or property?
A. It depends. If you are related to a person in ways approved under the law, you may. You may if you have title to real property or personal property, such as a car or boat. If your company considers you to be a key military officer or film director or director, it may take out a life policy on your life to benefit the business .
Anyone seeking to buy policy on other people or property must have an ” insurable interest ” at the time the indemnity contract is made and sometimes when the loss occurs, besides. The law is found at Ark. Code Ann. §§ 23-79-103 ( for policy interests in people ) and 23-79-104 ( for policy interests in place ) .
Q.        What is the “Valued Policy” law on total fire losses of buildings and real property?
A. The rate policy jurisprudence, Ark. Code Ann. §23-88-101, covers losses on real property, such as a firm, from fire and natural disasters. basically the valued policy law says that, absent an insurance company defense such as arson or early policy imposter, the insurance company for a entire personnel casualty on very property owes the entire boldness sum ( total policy price in $ dollars ) of the policy without disparagement or contesting the prize. indemnity companies in rural areas must pay rural volunteer fire fighter claims out of the policy proceeds first before paying the homeowner if the homeowner has not paid its rural district fire association dues timely, under Ark. Code Ann. § 23-88-102. The respect policy jurisprudence does not apply to :

• flood or earthquake losses; or

• detached or appurtenant structures.  Contact your insurance producer or your carrier about a rider or endorsement to cover these other structures. 

Q.       How can I tell if my insurance binder is any good? 
A. indemnity binders are impermanent policies of indemnity that are generally issued by indemnity producers, though sometimes they come target from the insurance company. But not every agent or manufacturer evening has authority from the policy party to issue a binder or short-run policy. Ask the agent or producer for something to show that he/she does have full authority, and that the insurance company will honor the terms of the binder. The binder must be replaced by a full policy in 90 days or less and the policy must match ( or not conflict with ) the wax policy when the consumer receives it .
Q.        I have a prepaid funeral contract with a funeral home. I now want to switch funeral homes and want to transfer the money I paid the first funeral home to the new one. Can I cancel with the first funeral home and transfer the money to the new one?
A. Yes, a long as the postpaid funeral contract was entered into by you before July of 1995. You need to notify the first funeral home you want to transfer your prepay funds over to a substitute funeral supplier ( the modern funeral home ). The law requires the first funeral home to transfer all of the proceeds to the newly funeral base, what you paid down to fund the contract, minus the built up pastime .
Q.        Do the State or Federal Do Not Call laws apply to the business of insurance and insurance agents?
A. Yes. The Department is able to provide you some general information, but please remember that the enforcement authority for the Do not Call law ( both State and Federal ) lies with the Arkansas Attorney General ‘s Office. Below is the connect to their web site for further information ; you will need to contact the Consumer Protection Division of the Public Protection Department : www.ag.arkansas.gov
Unlike the Federal Trade Commission ‘s Do-Not-Call rule, the Federal Communication Commission ‘s ( FCC ) Do-Not-Call Rule applies to the indemnity industry. indemnity agents who use the telephone or send faxes will have to follow the FCC ‘s Rule and check the national do-not-call list evening in states that have exempted insurance agents from their do-not-call rules ( like Arkansas ! ). If an agentive role has an “ lay down occupation relationship ” with a client and that client has placed his or her name on the do-not-call list, the agent is still allowed to call his or her node at home. An establish clientele relationship exists where the customer has made a purchase or entered into another transaction within the 18 month menstruation prior to the call or when an inquiry or lotion has been made within 3 months before the call. Nonetheless, “ cold ” calls to numbers on the Do-Not-Call list are prohibited unless express written license has been given to call .
submission with the FCC Do-Not-Call Telemarketing Rule has been required since 10/1/2003. There is besides a Do-Not-Fax Rule effective 1/1/2005 .
besides, the National Association of Insurance and Financial Advisors has made a joint file with the american Council of Life Insurers ( ACLI ) in 11/2003 asking the FCC to clarify the definition of “ establish business relationship ” under the do-not-call rules .
The Department encourages you to contact the FCC directly and inquire about the applicability of the federal Law to intra-state phone calls, i.e., call calls made in-state only from an AR producer to an AR consumer. It is the Department ’ s understanding that there is existing confusion as to the applicability of the former state-exception for indemnity under the newly Do not Call provisions. The FCC ‘s web site and reach information is : hypertext transfer protocol : //www.fcc.gov/contacts.html
Q.        Are proceeds on life insurance protected from creditors? 
A. Yes, life proceeds are nontaxable as stated in Ark. Code Ann. 23-79-131 .
Q.        Are annuity proceeds protected from creditors? 
A. Yes, annuity proceeds are nontaxable as stated in Ark. Code Ann 23-79-134 .
Q.        If a company selling long-term care insurance goes into liquidation what would be covered under the Guaranty Fund?
A. The sum of coverage would be $ 300,000, or policy limits, whichever is less. The policies not in claim condition would be sold to a solution policy company. The policyholder would receive notice of this, a certificate from the assuming ship’s company and data as to where to send agio payments, make inquiries, file claims, etc. If the policy is in claim condition, the guarantee fund would pay on the policy until the terminus ad quem of coverage was reached .
Q.        I have a policy issued by Union Life Insurance Company.  Can you tell me who has control of this policy and who can I contact to discuss the policy?

A. In 1990 Union Life Insurance Company was merged into Jefferson National Life Insurance Company. Jefferson National was belated merged into bang-up american Reserve and Great American Reserve was late merged into Conseco Life Insurance Company. Union Life ’ sulfur biography occupation was transferred into Conseco Variable Insurance Company. Conseco variable Insurance Company changed its list to Jefferson National Life Insurance Company and entered into an agreement with Protective Life Insurance Company of Birmingham, Alabama to service the Union Life clientele. You may call 1-800-866-3555 to talk to a customer service representative. To inquire about your policy use the letters KK and then your original policy count when referring to your policy count .
Q.        Must a licensed automobile dealer provide primary insurance on loaner cars?
A. No. typically, insurance coverage follows the car and not the person. however, Ark. Code Ann. § 27-19-713 ( fifty ) provides an exception to licensed car dealerships ; under this legislative act, they are not required to carry primary insurance coverage on every vehicle in their car lot. This law eases the indemnity burden on the dealerships by extending the insured ’ second coverage to instances in which the franchise loans a vehicle to the insured .